Mantoglu Baris, Altintoprak Fatih, Firat Necattin, Gonullu Emre, Dikicier Enis, Akdeniz Yesim, Aziret Mehmet, Erkorkmaz Unal
Sakarya University Educating and Research Hospital, Department of General Surgery, Serdivan, Sakarya, Turkey.
Sakarya University, Faculty of Medicine, Department of General Surgery, Serdivan, Sakarya, Turkey.
Emerg Med Int. 2020 Sep 15;2020:6039862. doi: 10.1155/2020/6039862. eCollection 2020.
Although laparoscopic appendectomy increases its popularity today, the answer to the question of whether to perform open or laparoscopic appendectomy during pregnancy is appropriate in many studies, and the choice of surgery depends on the surgeon. Herein, we aimed to evaluate the variables that affect undesirable pregnancy outcomes that occur as a result of appendicitis during pregnancy.
Seventy-eight pregnant patients with acute appendicitis who underwent laparoscopic or open technique intervention enrolled in this retrospective study. In addition to the demographic structure of the patients, surgical technique, the number of pregnancies, multiple pregnancy status, surgical pathologies, laboratory values, radiological imaging methods, and length of hospital stay were evaluated. The severity of appendicitis was classified according to the pathology results. The patients were divided into two groups according to the outcomes of their pregnancy. Preterm delivery and abortion involved in the study as a single complication section.
The mean age of the pregnant patients was 28.6 ± 5. Of the 78 pregnant women with appendicitis, 47.4% had their first pregnancy, 37.2% had their second pregnancy, and 15.4% had 3 or more pregnancies. The preterm delivery and abortus were 19.5% in the open appendectomy (OA) group and 16.2% in the laparoscopic appendectomy (LA) group. No statistically significant difference was detected in this group in terms of appendicitis pathology triggering preterm delivery or abortion ( 0.075). When white blood count (WBC) and C-reactive protein (CRP) were evaluated by laboratory findings, CRP was found to be statistically significantly higher in patients with preterm birth ( 0.042).
Consequently, acute appendicitis may cause serious intra-abdominal infection and inflammation in addition to the complexity of the diagnosis due to the nature of pregnancy, as well as undesired pregnancy outcomes with the surgical technique, or independently with other variables.
尽管腹腔镜阑尾切除术如今越来越受欢迎，但在许多研究中，对于孕期是进行开腹还是腹腔镜阑尾切除术这一问题尚无定论，手术方式的选择取决于外科医生。在此，我们旨在评估影响孕期阑尾炎导致不良妊娠结局的相关变量。
本回顾性研究纳入了78例行腹腔镜或开腹技术干预的急性阑尾炎孕妇。除患者的人口统计学结构外，还评估了手术技术、妊娠次数、多胎妊娠状态、手术病理、实验室检查值、放射影像学检查方法以及住院时间。根据病理结果对阑尾炎的严重程度进行分类。根据妊娠结局将患者分为两组。早产和流产作为单一并发症纳入研究。
孕妇的平均年龄为28.6±5岁。78例阑尾炎孕妇中，47.4%为首次妊娠，37.2%为第二次妊娠，15.4%为3次及以上妊娠。开腹阑尾切除术（OA）组的早产和流产率为19.5%，腹腔镜阑尾切除术（LA）组为16.2%。在该组中，未发现阑尾炎病理引发早产或流产方面存在统计学显著差异（P=0.075）。根据实验室检查结果评估白细胞计数（WBC）和C反应蛋白（CRP）时，发现早产患者的CRP在统计学上显著更高（P=0.042）。
因此，急性阑尾炎除了因妊娠性质导致诊断复杂外，还可能引起严重的腹腔内感染和炎症，以及因手术技术或与其他变量独立相关而导致不良妊娠结局。
